Metabolic syndrome

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Carnivore for Alzheimer’s Prevention – A No Brainer

Globally, every three minutes, someone develops dementia. By 2050, an estimated 152 million people will have dementia. So chances are you know someone – a parent, grandparent, or friend – has as suffered from this horrible disease as well. But contrary to popular belief, Alzheimer’s Disease (AD) is not a normal part of aging. It can be prevented. The key is to take action as soon as possible since it’s thought that AD begins 20 years or more before symptoms arise. Keep reading to learn more about the causes of dementia and the choices you can make to avoid this terrible disease.

What is Alzheimer’s Disease?

AD is a progressive neurodegenerative disease characterized by the progressive decline of memory, cognitive functions, and changes in behavior and personality. Sadly, AD is the 6th leading cause of death in the United States and the 5th leading cause of death for those aged 65 and older. AD is the most common type of dementia, a category of mental impairment that also includes cerebrovascular disease (vascular dementia) and Lewy body dementia.

What are the Risk Factors for Dementia?

Dementia can be prevented and, in some cases, early symptoms can be reversed. Risk factors for dementia can be categorized into modifiable and non-modifiable. Non-modifiable risk factors include age, genetics, gender (women are more likely to have Alzheimer’s), and a positive family history of dementia since more than one-third of AD patients have one or more affected first-degree relatives.

The good news is that there are modifiable risk factors – areas where our choices can mitigate dementia. Modifiable risk factors include avoiding smoking, head injury, environmental factors, and metabolic syndrome (MetSys), one of the fundamental causes of dementia. MetSys is a signal that the body is not properly handling carbohydrates and is, therefore, a risk factor for obesity, Type 2 diabetes, heart disease, and hypertension. Treating MetSys minimizes the risk of Alzheimer’s and other dementias in 40% of the population.

Alzheimer’s Dementia is a Metabolic Issue

While the cause of AD is multifactorial, with both genetic and environmental factors implicated in its pathogenesis, AD is arguably a metabolic issue that stems from the brain’s inability to harness energy from glucose. In addition to these lifestyle choices, we can modify (lower) our risk of AD through dietary choices.

The brain is an energy-hungry organ. Although it only typically accounts for 2% of body weight, it can require up to 20% of the body’s glucose and oxygen. That’s why adequate fuel delivery is so important. Compared to healthy people, those with AD have been found with up to a 45% reduction in the cerebral metabolic rate of glucose or CMRglu. This results in reduced fuel usage by brain regions responsible for memory processing and learning. Because areas of the brain dedicated to visual and sensorimotor processing are unaffected, it can be difficult to notice changes, even though the risk of developing AD is present. A decline in glucose metabolism can be detected decades before overt symptoms.

Type 2 v Type 3 Diabetes

You may have heard the terms “Type 3 diabetes” or “diabetes of the brain” because similar to Type 2 diabetes, the brain becomes incapable of adequately metabolizing glucose due to insulin resistance (or insulin insensitivity). Without adequate fuel, neurons in regions of the brain start to degenerate. Degraded neurons eventually become incapable of communicating, leading to symptoms associated with AD such as confusion, cognitive decline, and behavioral changes.

Type 2 and Type 3 diabetes are related in that they may have the same primary underlying cause of insulin resistance, but they are not the same. An individual does not need to be diagnosed with Type 2 diabetes in order to develop Type 3 or AD. In fact, many people with AD have normal blood glucose levels and are not diagnosed with diabetes. The key factor is, therefore, not glucose, but insulin resistance, a reduction in the body’s sensitivity to insulin, and hyperinsulinemia (elevated levels of insulin in the bloodstream for extended periods of time.) These disturbances lead to inflammation and oxidative stress, an imbalance of free radicals which can create damage to the cells and tissue in the body. While Type 2 diabetes affects muscles, organs, and the rest of the body aside from the brain and central nervous system, damage from AD is localized to the brain.

Insulin and Beta-amyloid Plaques

Interestingly, insulin also plays a crucial role in the formation of amyloid plaques, protein fragments that accumulate in the brain. While these plaques are found in healthy brains, in AD patients, beta-amyloid plaques accumulate to an unhealthy level, interfering with cell communication. Aside from reduced glucose utilization, beta-amyloid plaques are one of the defining features of AD.

One theory as to why these plaques accumulate in the AD brain is that they are not broken down and cleared away as they should be. Beta-amyloid plaques are primarily cleared with insulin-degrading enzyme, the same enzyme the body uses to clear insulin once insulin has done its job. Because the enzyme prefers insulin to beta-amyloid plaques, it works on clearing insulin first, leaving plaques to accumulate. Chronically-elevated insulin levels lead to more plaque build-up. And the more it builds up without being cleared, the more likely it is to form plaques that interfere with neuronal communication.

The Importance of Early Alzheimer’s Disease Prevention

This article cannot overstate the importance of AD prevention. AD begins with small changes in the brain that are initially unnoticeable to the person affected. Only after years of brain changes do individuals experience noticeable symptoms, at which point disease reversal may be too late. While there is no cure for AD, it can be prevented through dietary and lifestyle interventions. Consider prevention a lifelong concern. Waiting for an AD diagnosis may be too late – the brain may have already suffered too much damage.

Dietary Changes for AD Prevention

Carbohydrate restriction by way of a carnivore, keto, or ketosis-inducing diet is one of the first steps we can take to begin to ease the metabolic dysfunction that causes AD. If the brain has become incapable of properly metabolizing glucose, then a low or no-carbohydrate diet utilizing another fuel source can help correct abnormalities. This alternate fuel source – ketones – are generated when the body switches from metabolizing carbohydrates to metabolizing fat. In a low insulin environment, the body will produce ketones, a product of fat burning, to provide the brain with nourishment.

“The therapeutic and neuroprotective effects of ketones are so impressive, in fact, that one of the premier researchers studying ketones and brain health has suggested that a drawback of the modern, carbohydrate-heavy diet is that is it ‘keto-deficient.’” 

The Alzheimer’s Antidote

While the causes of AD are multifactorial, dietary changes can play a significant role in preventing or even reversing AD symptoms. The price of poor brain health is too high to delay starting to pay attention today. To learn more about Alzheimer’s prevention using a low-carb diet, please refer to Amy Berger’s book, The Alzheimer’s Antidote.

Written by Laura Guy
I dedicate this article to my father, Stuart. I love my father dearly and have watched him transition from an ambitious, independent man to an immobile and totally dependent man with very little speech capacity. Sadly, he has experienced very little quality of life over the past 11 years due to the degenerative effects of dementia, a disease for which there is no cure.

Getting Hung Up on Health Markers

Often when people follow some form of a low-carb diet, they focus on monitoring certain things through blood testing to get some insight into the effects of diet. Blood testing provides some data and often can help to troubleshoot problematic health issues. Before I get into some of the common observations that I’ve made about carnivore dieters, let me put some things into perspective.

When you have your blood drawn, its contents are representative of what is being transported via your blood during that exact moment in time. Many, if not most, of the things that can be measured in the blood can change on a weekly, daily, hourly, and even momentary basis. For instance, blood cholesterol can change dramatically over a few days, hormones can change by the hour, and liver enzymes or inflammatory markers can go up or down based on recent activity or exercise levels. Lab values can be significantly affected by many things, including stress, sleep, illness, activity, exercise, weather, temperature, time of day, and time of year. So, trying to attribute any one particular laboratory reading exclusively to diet can be problematic.

Just as the nutrition science–based food recommended daily allowances were based on a population that was arguably sick from eating a high-carbohydrate, grain-based diet, many of the common laboratory reference ranges were based on that same population. We truly do not have a good set of reference ranges for the populations who follow the low-carbohydrate and carnivore diets. With this in mind, I want to share some of the areas where labs for carnivore dieters can diverge from the general population.

Blood Lipids

Blood lipids probably cause the most concern for both patients and their physicians. First of all, blood lipid levels are dynamic; they can vary fairly significantly over a matter of even a few days. Your total cholesterol on Wednesday may be remarkably different the following Tuesday. Let’s assume that the numbers you get represent a daily average. (However, this assumption is likely false.) When we look at the lipid number for a carnivore dieter, we often see elevated total and LDL cholesterol; this is not always the case, and often LDL/total cholesterol will be largely unchanged or even lower.

Another common finding among carnivore dieters is a general trend toward elevated HDL, the so-called good cholesterol, and generally lower triglycerides. In general, higher HDL and lower triglycerides are thought to represent an improvement in cardiovascular risk, but this is not absolute, particularly regarding the HDL. As I’ve already mentioned, it’s important that you realize that large energy shifts and weight loss can be responsible for unexpected numbers, such as higher than expected triglycerides, particularly at the beginning of a transition to the carnivore diet. I often suggest that people wait six months or more before getting routine labs after starting the diet, unless there’s a compelling reason to do it earlier, such as to address an illness.

Glucose

Glucose control is important, and generally speaking, a carnivore diet tends to lead to very well-controlled glucose numbers. If you’re going to talk about glucose, then you definitely need to be aware of your insulin status. When you look at a blood glucose reading in isolation, you leave out a major part of the story of blood sugar control, potential diabetes, and other chronic disease risks. If you’re going to worry about heart disease, insulin sensitivity is one of the most important modifiable risk factors you can be concerned with. It’s right up there with smoking, and it’s far more important than relative cholesterol levels. You can use a fasting insulin level with a fasting glucose level to calculate something called a HOMA-IR score, which is one of several reasonable measures of insulin sensitivity.

In general, a carnivore diet tends to lead to improved insulin sensitivity over the long term. Glucose tends to remain stable for people on the carnivore diet because the glucose the body is using is not being ingested; it’s being produced mostly from protein, a small amount of fat, and a few other sources, such as lactate, via a process generally described as gluconeogenesis. Gluconeogenesis is probably the most precise way to control glucose regulation, and in the long term, it leads to well-controlled and stable blood glucose numbers. People with both type 1 and type 2 diabetes also note that in the long term they tend to see excellent blood glucose control, although it may take a few months for the level to normalize.

Liver Function

Liver function studies tend to be normal for people on the carnivore diet, and the assumption that increased protein is damaging to the liver is based upon a fallacy. NAFLD (non-alcoholic fatty liver disease) is an increasingly common diagnosis. Fortunately, we know from observations of carnivore populations and by extrapolating data from low-carbohydrate studies that a carnivore diet tends to improve this problem. Liver function tests can be slightly elevated for several reasons, and if you’re having them evaluated, you should be aware of benign reasons for their elevation. One of the more common reasons is recent intense exercise, which can result in slight elevations of these enzymes for up to a week.

Inflammation

In a similar vein, markers of inflammation, such as C-reactive protein, can show a transient elevation after exercise or other acute stresses on the body. This marker and other inflammation labs can be used as risk factors for predicting cardiovascular or other disease potentials. Once again, it appears that a carnivore diet tends to lead to low levels of inflammatory markers.

Kidney Function

Kidney function is often a concern with higher protein diets, but the concern stems from data from animal studies that haven’t been replicated with humans. In general, the consensus is that high-protein diets do not damage kidneys. Some people still are concerned that an already damaged kidney will fail more quickly in the presence of higher levels of protein, but that data is tenuous at best. We have some reports of improved renal function in people who’ve followed a carnivore diet. If you have compromised renal function and are concerned that consuming too much protein while on a carnivore diet might be problematic, it’s worth your effort to track the function over time.

Hormone Levels

Thyroid function is generally improved on a carnivore diet, and we have observed improvements in autoimmune-related issues such as Hashimoto’s thyroiditis. One interesting thing to note is that thyroid hormone, particularly T3 levels, may seem to be low, but the clinical function is noted to be good. This likely represents a decreased requirement for circulation of the hormone or an increase in receptor sensitivity. Therefore, you should not need a supplement in the absence of a clinical need.

Similarly, when people follow a carnivore diet, reproductive hormones tend to normalize and function optimally. It becomes very important to consider clinical function as we assess particular hormone levels. Both men and women note improvements in libido and clinical testosterone function when they follow a carnivore diet, particularly after they’ve moved beyond the adaptation phase.

Iron Levels

Iron deficiency is one of the most common deficiency problems in the world, and a carnivore diet is undoubtedly the most efficacious way to prevent that problem because it’s tremendously high in bioavailable heme iron. On the other hand, too much iron, particularly when stored in excess quantities in the tissue, has been associated with some health problems, such as diabetes, cardiac disease, or liver disease.

Fortunately, excess iron levels don’t seem to occur to any significant degree on a carnivore diet. It’s likely that underlying metabolic disease and inflammatory states contribute to excess iron storage. In general, a carnivore diet tends to improve those conditions, and that may be the reason why high storage levels as assessed by serum ferritin don’t seem to be a problem, even though carnivore dieters have a relatively high iron intake.

Miscellaneous Health Markers

In general, you can expect both red and white blood cell counts to fall within the normal ranges. However, you may see slightly lower white blood cell counts, which may be associated with a generally lower inflammatory state. Levels of serum electrolytes, such as sodium, potassium, chloride, calcium, and magnesium, tend to be normal. Our bodies do a pretty good job of maintaining these in fairly narrow physiologic ranges.

Some people express concern that a carnivore diet can lead to an acidic environment, but our blood pH is aggressively controlled and very tightly regulated. As long as we have functioning lungs and kidneys, we can keep our blood pH right where it needs to be regardless of dietary input.

The concerns about acids leaching minerals from our bones for buffering purposes are unfounded. Higher protein diets ultimately lead to better long-term bone health, especially because our bones are approximately 40 percent protein.

Excerpted from The Carnivore Diet, By Dr. Shawn Baker.
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